Abdominal Exam Flashcards
What are common symptoms of upper abdominal symptoms? (7)
Dysphagia
Anorexia
Weight loss
Reflux
Dyspepsia
N&V
Haematemosis
What are the common symptoms of lower abdominal disorder? (6)
Abdo pain
Wind
Rectal bleeding
Constipation
Diarrhoea
Incontinence
Describe visceral pain
This is a poorly localised dull, deep, aching, cramping pain
Describe somatic pain
A localised sharp, burning, throbbing, and dull ache
What is McBurney sign positive?
A deep tenderness at McBurneys point. This is a sign of late stage appendicitis and may rupture
How to test the psoas sign?
Whilst lying down if the patient flexes their right hip (lift their right leg against resistance) and they experience pain in the LRQ this is a positive psoas sign
Why does someone with appendicitis experience pain when testing the psoas sign?
Because the iliopsoas muscle lies under the appendix. So aggrevating the iliopsoas with aggrevate the appendix
How do you test for Rovsing sign?
When you palmate the lower left quadrant the patient will experience pain in the right lower quadrant
How do you test for Rovsing sign?
When you palmate the lower left quadrant the patient will experience pain in the right lower quadrant
How to test for the obturator sign in appendicitis?
Flex the leg at the hip and rotate the knee internally (bring the foot towards you) the patient in experience more pain in the LRQ
What’s the Dumphy sign for appendicitis?
Abdo pain when you cough
What are three causes for cyclical abdo pain for women (3)
Primary dysmenorrhoea
Endometriosis/adenomyosis
Mittelschmerz
What are some causes for non cyclical abdominal pain in women? (4)
Uti
Pelvic inflammatory disease
Ovarian cyst accident
Adhesions
What is duputrens contracture?
Chronically contacted fingers due to thickening of the skin in the hands
What is a common term for asterixis?
Liver flap
What is koilonychia?
Spoon shaped nails associated with iron deficiency
What is leukonychia?
Whitening at the nail bed - associated with hypoalbuminaemia
What is acanthosis nigricans?
Darkening and thinking if the arm pit skin.
It’s associated with insulin resistance, GI cancers or hormones are out of wack
What is kayser-fleisher ring?
A copper ring around the iris accosicated with Wilson disease
How many spider naevi is concerning and what is it associated with?
> 5 ans can be accosiated with liver cirrhosis
What is caput medusa?
This is swollen veins found of the abdomen caused by an blockage of the portal vein
What is Cullen sign?
Bruising around the umbilicus associated with haemorrhagic pancreatitis
What are the 7 Fs of abdominal distension?
Fat, fluid, feotus, faeces, fibroid, full bladder, filthy big tumour
How long should you listen to bowel sounds for ?
1-5 minutes
What might be a cause for no bowel sounds?
Paralytic ileus
Intestinal failure
Generalised peritonitis
What can cause high pitched and tinkling bowel sounds?
Sub acute intestinal obstruction
When ausulating the organs. What are you listening for?
Bruits
Rubs
Venous hums
When their is an increase liver during percussing. Why might their be?
Liver meglia or lung consolidations
During percussion the liver appears decreased in size. Why might this be?
Due to cirrhosis, free air under the diaphragm or gas in the colon pushing on the liver (false decrease)
What is the castells method?
This is when you percus for the spleen at the castell point (the last intercostal space) and the patient breaths in if there is a shift from resonance to dull this is a positive sign
What is rebound tenderness?
When you get sudden abdo pain on rapid release of the abdo wall
What is Murphy sign positive?
When you align with the right clavicular midpoint where the right abdominal rectus muscle intersects with the costal margin.
Palpate the gallbladder area, and as the patient breathes in, tip your fingers towards the gallbladder. A sudden pain suggests cholecystitis
How do you palpate for the spleen?
Start at the right iliac fossa and move diagonally across the abdomen to the left costal margin.
Palpate like you could the liver. You shouldn’t feel the spleen normally
When palpation the kidneys if you can feel them and are tender what might this suggest?
Hydronephrosis
How do you test for ascites?
Shifting dullness
During a digital exam, if a patients rectum is hypertonic. What might this suggest? (4)
Crohns
Fissure
Stricture
Nervous
During a digital exam, if a patients rectum is hypotonic. What might this suggest? (3)
Old age
Nerve damage
Muscle damage
What is a hernia?
An abnormal protrusion of a structure, irgan or part of an organ put of the cavity it belongs to
What sort of hernia can’t you reduce?
Strangulation hernias
